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Blood Transfusions and IV Catheter Gauge

A common question I get asked and recently, a comment was posted here by Lori.

“I am a CRNI working in a hospital. I am the first CRNI they have had and I am also the ONcology Coordinator. I have been updating many policies. I am having trouble finding info to back up the need to update our blood infusion policy. We have a large geriatric population that have poor veins. The nurses stick these patients countless times to get a 20 gauge in when they have a perfectly good 22 gauge already in. I want our policy to allow for the smaller gauge catheters in cases of poor veins. Any articles or current writings out there?”

The practice is to use a catheter gauge that would accommodate the infusion of blood and/or blood components, usually a 20g IV catheter. To answer your question, here is a list of articles I found, some of them are older than 10 years but I hope you find them useful.

Last point on your comment, I hope that your nurses do not really stick your patients “countless times”. Perhaps reviewing the INS standard might help… “no more than two attempts at cannulation by any one nurse should be made”.